Tuesday, March 5, 2013
My summary of the #HIMSS13 keynote by Dr. Eric Topol on day #2
He came on stage wearing his Walking Gallery jacket painted by Regina Holliday. We saw a surge of tweets from the medical community praising Regina for her patient advocacy efforts through her growing Walking Gallery.
Eric entertained the audience with some photos challenging the notion of "what is a digital native?" It seems that unless you started using a smartphone when you were in the womb, you are probably a digital immigrant. We have all immigrated to the digital world.
He also spoke about the current state of medical care. Patients are getting treated as equals right now. We are not routinely incorporating genomic data on specific patients, but we have the capability of doing that right now.
Wearable sensor technology is also gaining momentum in the world of consumer health. We can wear Fitbits and wrist bands that can help people measure, track, and share their physical activity, their sleep, and much more. Top pro athletes are even monitoring their sleep.
On stage, he pulled out his smartphone and showed the audience his AliveCor pocket ECG and his own heart rate. He also demonstrated his own pulse ox by placing a sensor on his fingertip and plugging the device into his smartphone. On his wrist, he had an "ICU on your wrist" that also measured his blood pressure and other biometrics. His point was that we are digitizing health care. Traditional medical equipment like stethoscopes are getting replaced with digital devices that can show how the heart is beating. We now have gadgets that can attach to smartphones and empower patients with medical devices that can evaluate eyes, ear drums, hearts, lungs, and more. We can do so much health monitoring at home. The era of the "smart home" is upon us.
So, when will the robot replace doctors? Is your doctor becoming obsolete? Will artificial intelligence and super computers replace some trivial, algorithmic clinical decisions that are being made by physicians?
At Scripps, they are actively engaged in research evaluating the impact of medical sensors in disease management. Expect some interesting research to emerge later this year from Scripps.
He made a transition into genomics. We have seen the cost of human genome sequencing dramatically come down, so the future of medicine will be dependent on human genome information. He gave a few examples of young children who have been treated highly effectively based on their genomic information. The era of truly "targeted therapies" will be a new era in medicine. We will be targeting specific genetic defects and mutations. We see some of this right now in cancer treatment. Tumors like melanoma are being treated effectively if patients have a certain mutation that can be targeted with some new drugs.
We need MOOM: Massive Open Online Medicine
Will we get there? Will the culture of open source, open publishing, open information sharing permeate the medical field? I hope that happens in our lifetime. I hope that we see a culture shift that embraces openness and information sharing for true collaboration and research advancement.
We have sensors in our cars, so why don't we have sensors in our bodies? We can predict a heart attack before it happens. Maybe someday we will all have a tiny sensor that will trigger a "heart attack" ring tone if it detects that we are about to have a heart attack.
We are seeing the end of paternalistic medicine. Patients are entitled to their own medical information. A growing number of patients want all of their health data. He mentioned the RWJF OpenNotes project and a JAMA article that asks the question, "should patients have access to their lab results?"
The Doctor is supposed to be the Teacher.
The new flywheel of medicine is access to your own health data.
He ended his presentation with a "show me the data" parody based on the 1996 Jerry Maguire movie.
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